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Friday, November 14, 2014

Keypad or Touchscreen: Which is the Lesser of Two Evils?

The fact that cellular phones and other mobile communication devices can become contaminated with potentially pathogenic organisms is not new. To my knowledge, the Brady article, “Is Your Phone Bugged”, from the American Journal of Infection Control was first to identify these devices as potential reservoirs for pathogens.  Even when cellular phones were banished from hospitals, Brady discovered that up to 25% of healthcare workers’ personal phones were contaminated with healthcare-associated microbes, including MRSA and VRE.  As concern about disturbance of electromagnetic fields diminishes - even airlines allow us to keep our phones and tablets on -  mobile phones and other such high-touch communication devices are making strong inroads to acute care settings. Their presence is generating new studies on the infection transmission risk associated with their use.

A group from University College London published an article in the Journal of Infection Prevention, comparing keypad phones to touch screen phones, particularly in an acute care hospital setting (“Keypad mobile phones are associated with a significant increased risk of microbial contamination compared to touch screen phones”,). The authors observed that the majority of healthcare professionals use the same mobile phone inside and outside the workplace, and thus risks contamination to other departments, hospitals, and the community. Many of the phones in use today have touch screens with a solitary smooth surface, as opposed to a keypad with separate buttons and numerous crevices. The authors postulated that, of the two styles of devices, bacterial contamination would be lower on touch screen phones.

Even in this rather small sampling, the results were telling.  Nine of the 67 samples grew either MRSA or VRE, all but one of those being from keypad phones. All of the “on-call” phones were keypad models, which might have skewed the results, since 40% of these phones showed MRSA or VRE contamination. Of the touch screen phones, 17 were iPhones, none of which were contaminated with potential pathogens.  To confirm their results the authors repeated the study in another hospital, and with a larger sampling of 126 touchscreen phones, and 47 keypad phones. This second facility had a lower baseline MRSA rate than in the first hospital. In this second attempt, 5 of the touchscreen phones (4%) were contaminated with MRSA. None of the keypad phones were contaminated with MRSA or VRE, but overall the bacterial colony counts were higher with keypad phones.

The authors concluded that touchscreen phones have lower bacterial colonization when compared to keypad phones. Keypad mobile phones were more likely to be contaminated with higher colony counts of bacteria, and the majority of drug-resistant bacteria were isolated from keypad phones. The keypad is the area in contact with the fingertips, and intermittent handling of mobile phones during and between patient consultations is a means for transmission and conceivably reduces the effectiveness of hand hygiene.

I suppose I should be "happy" that my iPhone and iPad, which are frequently played with by my 5-year son, would be expected to have fewer bugs than similar devices with keypads. That is, at least before he got his hands on them!  But moving outside of the hospital where the frequency of cleaning and disinfection does not occur with the same frequency, what level of contamination would we see?  I shudder at the thought of the level of contamination to be found on the keypads of debit machines.....how many times have you paid for groceries and then proceeded to have a snack on the way home without cleaning your hands first? To that I can answer....not anymore!

Bugging Off!

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